. 2020 Jan 3;10:1. doi: 10.1186/s13601-019-0303-6

Table 10.

Summary of the evidence for ‘efficacy of systemic steroids in pediatric sinonasal disease’

Study	Year	LOE (1a to 5)	Study design	Study groups	Clinical end-point efficacy	Conclusion
Ozturk et al.	2011	1b	RCT	1. Children with CRSsNP (6–17 years) receiving antibiotics and methylprednisolone 1 mg/kg and reduced progressively over a 15-day treatment course 2. Children with CRSsNP receiving antibiotics and placebo	1. Change in mean symptom and CT scores pre- and post-treatment 2. Change in individual symptom scores, relapse rate	Beneficial effect of MP in combination with antibiotics on mean symptoms, CT scores, VAS for cough, nasal obstruction and post-nasal drainage. No difference in relapse rate
Scorpinski et al.	2008	3b	Retro-spective uncontrolled	1741 children with CRS treated with antibiotics, intranasal topical corticosteroids and oral corticosteroids (> 4 days) or combination	CT scores	Improvement of CT scores after oral corticosteroid treatment, in mono- or pluritherapy
Tosca et al.	2003	4	Uncontrolled prospective cohort study	30 asthmatic CRS children treated with antibiotics, intranasal steroids and a short course of deflazacort (1 mg/kg daily for 2 days, 0.5 mg/kg daily for 4 days and 0.25 mg/kg daily for 4 days)	Nasal endoscopy and cytokine patterns in nasal lavages	Resolving of purulent discharge after combination treatment and decrease of mean IL4-levels in nasal lavage

Study

Year

LOE (1a to 5)

Study design

Study groups

Clinical end-point efficacy

Conclusion

Ozturk et al.

2011

RCT

1. Children with CRSsNP (6–17 years) receiving antibiotics and methylprednisolone 1 mg/kg and reduced progressively over a 15-day treatment course

2. Children with CRSsNP receiving antibiotics and placebo

1. Change in mean symptom and CT scores pre- and post-treatment

2. Change in individual symptom scores, relapse rate

Beneficial effect of MP in combination with antibiotics on mean symptoms, CT scores, VAS for cough, nasal obstruction and post-nasal drainage. No difference in relapse rate

Scorpinski et al.

2008

Retro-spective uncontrolled

1741 children with CRS treated with antibiotics, intranasal topical corticosteroids and oral corticosteroids (> 4 days) or combination

CT scores

Improvement of CT scores after oral corticosteroid treatment, in mono- or pluritherapy

Tosca et al.

2003

Uncontrolled prospective cohort study

30 asthmatic CRS children treated with antibiotics, intranasal steroids and a short course of deflazacort (1 mg/kg daily for 2 days, 0.5 mg/kg daily for 4 days and 0.25 mg/kg daily for 4 days)

Nasal endoscopy and cytokine patterns in nasal lavages

Resolving of purulent discharge after combination treatment and decrease of mean IL4-levels in nasal lavage

RCT randomized controlled trial, CR chronic rhinosinusitis, CRSsNP chronic rhinosinusitis without nasal polyps, CRS chronic rhinosinusitis. CRSwNP chronic rhinosinusitis with nasal polyps, MP methylprednisolone